Safety Plan for Borderline Personality Disorder

Information presented in this article may be triggering to some people. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. For more mental health resources, see our National Helpline Database.

Developing a well-structured safety plan is a critical component of managing Borderline Personality Disorder (BPD). Individuals with BPD face an elevated risk of attempting suicide or engaging in other high-risk activities. Without a safety plan, you might be at risk of harming yourself or others. A comprehensive safety plan can mitigate these risks and reduce the likelihood of impulsive decisions with severe consequences.

This article provides a step-by-step guide to creating a clear and thorough safety plan. It is crucial to prepare this plan in advance, rather than during a mental health emergency.

1. Engage Your Therapist:

   If you have been receiving therapy for BPD, discuss the development of a safety plan with your therapist. They can provide valuable insights, tailor the plan to your specific situation, and recommend additional elements to include.

   In the absence of a therapist, consider finding one. Therapy is an excellent investment for maintaining and enhancing your emotional well-being, just as regular medical check-ups are important for your physical health.

2. Assess Your Behaviors:

   In collaboration with your therapist, carefully analyze your behaviors and identify those that pose potential dangers, including:

   • Suicidal thoughts, no matter how fleeting
   • Impulses to self-harm
   • Intentions to harm others
   • Violent tendencies

   The goal is to identify the behaviors that your safety plan will address.

   Additionally, evaluate factors that may increase your risk of completing suicide or harming others, such as access to weapons or potentially harmful medications.

   If necessary, your healthcare provider may help minimize these risks by temporarily storing your weapons or prescribing medications in smaller quantities.

3. Identify Triggers:

   Once you have identified the behaviors and symptoms that put you at risk, pinpoint the specific events, situations, people, thoughts, or emotions that trigger these behaviors or symptoms.

   For example, many individuals with BPD experience abandonment sensitivity, leading to intense emotional distress during perceived or real abandonment experiences. For them, these experiences could trigger suicidal thoughts or intentions to harm others.

   Create a list of these triggers to gain insight into what might precipitate harmful behaviors.

4. Cultivate Coping Resources:

   Now, identify ways to respond to your triggers in a manner that ensures your safety. These will serve as coping resources that you will use before your symptoms escalate into a mental health crisis.

   Develop a list of effective coping strategies for BPD that you are familiar with and have found helpful. This list can include:

   • Mindfulness meditation
   • Your therapist's emergency contact number
   • A directory of emergency mental health clinics and hospital emergency rooms
   • The National Suicide Hotline (1-800-273-8255)

5. Document Your Safety Plan:

   Consolidate all the gathered information into a structured safety plan. This plan should include:

   • A list of your risk behaviors
   • Triggers for each risk behavior
   • Coping strategies to employ before symptoms intensify
   • Emergency actions to take if the coping strategies do not mitigate the crisis

   Ensure that you have a step-by-step plan of action for each risk behavior.

6. Commit to Your Safety Plan:

   The final step is to commit to your safety plan. This involves:

   • Making a personal vow to adhere to the plan when necessary
   • Verbally committing to someone else that you will follow the plan

   By taking these steps, you are taking control of your well-being and reducing the risk of engaging in harmful behaviors.

Remember, a safety plan is a dynamic tool that can evolve as your circumstances and symptoms change. Regularly review and update your plan in consultation with your therapist to ensure that it remains effective and relevant.